Provider Demographics
NPI:1457646242
Name:B&B HOME CARE 1 INC
Entity Type:Organization
Organization Name:B&B HOME CARE 1 INC
Other - Org Name:B & B HOME CARE 11 INC B & B HOME CARE 111
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADM.
Authorized Official - Prefix:MRS
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:786-532-0124
Mailing Address - Street 1:20625 SW 114TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1020
Mailing Address - Country:US
Mailing Address - Phone:305-235-4884
Mailing Address - Fax:305-235-4884
Practice Address - Street 1:20625 SW 114TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33189-1020
Practice Address - Country:US
Practice Address - Phone:305-235-4884
Practice Address - Fax:305-235-4884
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:B & B HOME CARE 1 INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-09
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9866310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility